Sleep Patterns and Depression in Mothers and Fathers of Twins The demands of early parenthood and their impact on the ability to obtain rest and sleep are exponentially high for parents of twins. Mothers of twins are at particularly high risk for depression, and sleep restriction may play a role in this increased risk. Twin births have continued to rise over the last 25 years, increasing the number of parents at high risk for partial sleep deprivation, also known as sleep restriction. Moreover, over half of twins are born prematurely and thus require more vigilant care. Sleep restriction results in a cascade of negative effects for families of twins. Unrelenting infant care demands of two high-risk infants result in a lack of time for parents' personal needs, including the need for sleep. Free time that a parent may have to rest is obliterated by the need to care for a second infant. For many families, help from relatives is short-lived, and financial constraints preclude the ability to hire someone to provide assistance with child care. Additionally, sleep restriction is linked to depression and fatigue in postpartum women, which affect parents' ability to meet childrearing demands. Maternal depression has adverse effects on the quality of mother-child interactions and is associated with significant long-term negative effects on infants' cognitive and behavioral development. Fathers, as well as mothers, are at high-risk for sleep restriction because fathers often are actively involved in assisting mothers of twins with childrearing demands while also meeting their own employment responsibilities. The aims of this descriptive longitudinal study are to: (1) describe maternal and paternal sleep patterns during the early childrearing period for parents of twins, (2) examine relationships between sleep pattern data and parental depression, perceptions of fatigue, and quality of sleep when the twins are 40 weeks post- menstrual age and at 8 and 12 weeks post-twin discharge, (3) determine the effect of potentially related contextual variables (method of delivery, antepartum bed rest, infant feeding method, consolability of the twins, post-menstrual age, sleeping arrangements, care-giving assistance, parity, and employment) on sleep patterns, and (4) identify strategies parents use to increase their sleep. A sample of 85 mother/father pairs will be recruited from three hospitals. Actigraphy and sleep diaries will be used to measure sleep patterns; standardized instruments will be used to measure depression, fatigue, and quality of sleep. Related contextual variables and strategies parents of twins report as helpful to increase their sleep also will be assessed. Analyses will include descriptive statistics and multivariate mixed model analysis with repeated measures. Results from the proposed study are needed as they will contribute important information to identify mothers and fathers of twins at highest risk for sleep restriction and the possible resulting sequelae of depression and fatigue. Identifying compensatory strategies that parents of twins report as helpful to increase their sleep will provide preliminary information for a future intervention study to evaluate and test an intervention that minimizes sleep restriction to allow for optimal parenting of twins. The high demands of caring for newly born twins, many of who are born prematurely, prevent parents from obtaining adequate amounts of sleep and rest. Inadequate sleep hinders parents' ability to provide optimal care for their high-risk infants. The proposed project will examine relationships between sleep and depression and fatigue in mothers and fathers of twins and identify useful strategies to be tested in a future study to minimize sleep loss and its adverse effects. [unreadable] [unreadable] [unreadable] [unreadable]